<form id="__form_name__" enctype="multipart/form-data" method="post" action="" class="form_advanced">
    <input type=hidden name='parent' value='__id__'>
	<div class="modules-items">
        <bx_repeat:items>
            <div class="modules-item" style='float:left;width:30%'>
                <input type="hidden" class="form_input_checkbox" id="__name__" name="pathes[]" value="__value__" />
                <label for="pathes-__name__">__title__</label>
            </div>
			<div style='float:left'>
				<select name='parentcat[__name__]'>
					<bx_repeat:options>
						<option __option_selected__ value='__option_value__'>__option_name__</option>
					</bx_repeat:options>
				</select>
			</div>
			<div class=clear_both></div>
        </bx_repeat:items>
    </div>
    __controls__
</form>